Biomedical subjects

E Tøndevold

Publications and source records attributed to E Tøndevold.

29 records · Page 2Linked to original sources

PubMed1982

Blood flow rates in canine cortical and cancellous bone measured with 99Tcm-labelled human albumin microspheres.

Regional differences in bone blood flow rates in the femur and the tibia of dogs were measured with 99Tcm-labelled microspheres. The measurements show an average flow rate of 3.7 ml (100 g)-1 x min-1 in cortical bone. A more rapid pace was found in red marrow containing areas, with an average flow rate in the femoral head of 19.7 ml blood (100g)-1 x min-1, and in the femoral neck of 50.3 ml blood (100 g)-1 x min-1. In the calcar femorale the average flow rate was 9.0 ml (100 g)-1 x min-1, and compared to cortical flow a positive correlation between strain and perfusion seems obvious. No difference between cortical bone in tibia and femur was found. The flow rates in the red marrow of the femoral neck are remarkably high, but the flow in the cortical bone is relatively low. It is concluded that handling of fragments of cortical bone and the associated soft tissue is presumably critical, and that the surgical technique has to be quite gentle to obtain optimal conditions for fracture healing.

Animals↗

PubMed1980

Costs of treatment of hip fractures. A calculation of the consumption of the resources of hospitals and rehabilitation institutions.

A series of 518 patients with hip fractures and a median age of 78 years was followed for 6 months. On admission to hospital the patients were assessed and were found to be evenly distributed among four social function groups according to their level of dependence on the social welfare system. At the 6 months follow-up the mortality rate was about 16 per cent, leaving 437 patients for a reassessment of social function. The average hospitalization time was 23 days; thus 17 per cent of all orthopaedic hospital beds in the area were occupied by patients with hip fractures. Patients staying the longest time in hospital were those waiting for discharge to a nursing home. The average stay in rehabilitation institutions was 71 days. The total rehabilitation course was longest for the most dependent patients. The risk of death or deterioration of social function among patients admitted from home was 48 per cent. In the case of social deterioration or technical failure following the fracture treatment the total rehabilitation course was considerably prolonged. The resources required for the treatment of hip fractures in a suburban area of 500,000 inhabitants were calculated to the 32 hospital beds, 43 rehabilitation beds and at least 21 nursing home beds.

Adult↗

PubMed1980

A prognostic evaluation of the hospital resources required for the treatment of hip fractures.

A retrospective study of 1,592 hip fracture patients over the age of 50 years was undertaken, recording the age and sex, the fracture type and treatment, the hospitalization time and the rate of technical failures. Based on the predicted population in the area of admission it was calculated that the number of hip fractures will double within the next 17 years. An analysis of the hospitalization time in relation to the various types of treatment and the rate of technical failures made it possible to calculate the hospital resources required in the future. It was found that despite the considerable increase in the number of hip fractures treatment can be undertaken without further allotment of resources provided a rationalized treatment plan is instituted aiming at the safest possible methods of treatment, as the hospitalization time was found to be considerably influenced by technical failures of the treatment.

Aged↗

PubMed1980

Stable trochanteric fractures. A comparative analysis of four methods of internal fixation.

A series of 375 patients with stable trochanteric fractures were treated with the McLaughlin or Jewett nail-plate, the sliding screw-plate or Ender nailing. Technical failure of fixation was encountered in 5% of the cases regardless of the method of fixation used. Re-operations were performed in less than 3% of cases treated with hip implants but in 20% of cases with Ender nailing, mainly because of distal slipping of the nails resulting in knee problems. With an improved technique, however, Ender nailing can be used as successfully as any of the hip implants for the internal fixation of stable trochanteric fractures.

Adult↗

PubMed1980

Unstable trochanteric fractures. A comparative analysis of four methods of internal fixation.

A series of 1,071 patients with unstable trochanteric fractures were treated by the McLaughlin or Jewett nail-plate, the sliding screw-plate or condylocephalic nailing according to Ender. Deep infection was encountered in 2.5% of the cases following surgery in the hip region and in 3.3% of the Ender nailings. Statistical analyses showed that the quality of the reduction was determined by the comminution of the fracture, and the technical failure of fixation or secondary displacement of the fracture was determined by the quality of the reduction. Sliding screw-plate fixation was found to be the only suitable fixation method for unstable trochanteric fractures, because of a low failure rate, a low re-operation rate and the possibility of secondary impaction without disturbing the fracture union.

Adult↗

PubMed1979

Mortality after hip fractures.

A survey was made of 1592 patients, over the age of 50 years, who had sustained a fracture of the hip. The mean age was found to be 77 years, and 76.9 per cent (1224/1592) of the patients were women. Trochanteric fractures accounted for 52.5 per cent (836/1592) of the cases and these patients had a higher mean age than those with femoral neck fractures. The average hospitalization time was 24 days and the mortality during the hospital stay was 8.6 per cent (137/1592). Statistical analysis revealed that the hospital mortality rate was related exclusively to the age and the sex. The mortality after 3 months was 17 per cent and that after 6 months 21.5 per cent. The survival rates paralleled the expected rate after 1.6 years but were found to be higher than expected after 2.8 years. The mortality after 1 year was 27 per cent, after 3 years 43 per cent and after 5 years 56 per cent.

Age Factors↗

PubMed1979

Relationships between oxygen and carbon dioxide tensions and acid-base balance in arterial blood and in medullary blood from long bones in dogs.

By means of an invasive technique the relations between arterial and medullary gas tensions PO2 and PCO2), and arterial and medullary acid-base balance (pH and standard bicarbonate) were determined in long bones in seven anaesthetized dogs. A semilogarithmic correlation was found between the arterial oxygen tension and the oxygen tension in the medullary blood. Between the arterial carbon dioxide tension and the medullary blood carbon dioxide tension a linear correlation was demonstrated A linear correlation was also found between arterial pH and standard bicarbonate values and the corresponding values obtained from medullary blood. With regard to the parameters investigated no difference was demonstrated between epiphyseal, metaphyseal or diaphyseal medullary blood.

Acid-Base Equilibrium↗

PubMed1979

Observations on long bone medullary pressure in relation to mean arterial blood pressure in the anaesthetized dog.

To study the influence of variations in mean arterial pressures (MAP) on long bone medullary pressures, seven anaesthetized dogs were investigated. The medullary pressures were measured in the epiphyseal, the metaphyseal and the diaphyseal regions and remained rather constant when MAP was above 80 mmHg. Below this level of MAP a statistically significant (P less than 0.01) reduction of the medullary pressures was seen. Comparing the mean medullary pressures obtained with ranges of MAP of 81--100 mmHg (the control medullary pressures) and of 61--80 mmHg, the greatest decline was seen in the epiphyseal and the diaphyseal regions, from 25.2 mmHg to 8.1 mmHg and from 26.7 mmHg to 8.3 mmHg, respectively. The corresponding decrease in the metaphyseal region was from 18.9 mmHg to 10.9 mmHg. The mean values of intraosseous pressure measured by our technique were between 20--30 mmHg and this is in accordance with measurements in normal humans found by other authors.

Animals↗

PubMed1979

Observations on long bone medullary pressures in relation to arterial PO2, PCO2 and pH in the anaesthetized dog.

To investigate the influence of variations in arterial oxygen tensions (PaO2), arterial carbon dioxide tensions (PaCO2), and arterial pH on long bone medullary pressures, seven anaesthetized dogs were investigated. Comparing the control medullary pressures, i.e. the mean medullary pressures obtained at the normal range of PaO2 (75--110 mmHg) with the mean medullary pressures corresponding to the range of PaO2 of less than 75 mmHg, statistically significant (P less than 0.05) decreases were seen in both epiphyseal, metaphyseal and diaphyseal medullary pressures, from 27.6 +/- 5.0 to 15.5 +/- 3.6 mmHg, from 23.5 +/- 2.9 to 13.9 +/- 2.3 mmHg and from 27.7 +/- 3.9 to 18.3 +/- 2.5 mmHg (all mean values +/- s.e. mean), respectively. Hyperoxia, hypocapnia, hypercapnia or metabolic acidosis had no effect on medullary pressures in any of the regions studied.

Animals↗

PubMed1979

Social rehabilitation following hip fractures.

A prospective 6 months' study of 518 patients with hip fractures was undertaken. The patients were classified into four social function groups on admission to hospital and again at the follow-up, according to their dependence on home-help and other services of the social welfare system. This dependency increased with the age of the patients. Life tables for the case material showed that the mortality depended more on pre-fracture social function than on age. At the follow-up, the risk of death or increased social dependency among primarily independent patients was found to be 38 per cent compared with 48 per cent among slightly dependent patients and 62 per cent in moderately dependent patients. A total of 17 per cent of the surviving patients admitted from home became nursing home patients. The pre-fracture social assessment determined the end-result to a greater extent than the age at the time of fracture. About 75 per cent of the patients discharged to their homes maintained their social function compared with 68 per cent of the patients discharged to a convalescent home and 47 per cent of the patients discharged to rehabilitation clinics.

Adult↗

PubMed1978

Unstable trochanteric fractures treated with the sliding screw-plate system. A biomechanical study of unstable trochanteric fractures. III.

Eighty unstable trochanteric fractures were treated with the sliding screw-plate system. Early weight-bearing was encouraged and mobilization was obtained within the first week in 47 per cent of the cases (37/78). Technical complications were encountered in 5 per cent of the patients (4/76) but none required re-operation. Telescoping of the screw occurred in 49 per cent (37/76). Through this secondary fracture impaction a stable load transmission system was established. Fracture union in the postoperative position was obtained in 49 per cent of the patients (37/76) and non-union did not occur.

Adult↗